Effective Health Promotion Interventions Research Articles

Effectiveness of a Nursing Student-led Comprehensive Health Promotion Program for Rural Older Adults: Toward Community-based Learning

Objectives This study investigates the effects of a nursing student-led comprehensive health-promotion program for rural older adults on perceived health, depression, cognitive function, and life satisfaction.
 Methods A non-equivalent control group pre-post study design was adopted, and rural older adults aged 65 years and over were divided into the experimental (n=41) and control group (n=31). The experimental group underwent a comprehensive health-promotion program once-a-week for six weeks. Data analysis was performed using SPSS 26.0 statistical program, and the differences in subjective health, depression, cognitive function, and life satisfaction between the experimental and control groups after the program were tested by independent t-test, and reliability was analyzed by Cronbach's α.
 Results There were no significant differences in perceived health, depression, cognitive function, and life satisfaction at baseline between the two groups. After the program, there was a significant difference in life satisfaction between the control and experimental groups, and no significant difference in subjective health, depression, or cognitive function; however, the pre-post paired t-test for life satisfaction in the experimental group was not statistically significant.
 Conclusions A comprehensive program developed based on the needs of rural elders was an partially effective nursing intervention in increasing life satisfaction. The findings of this study may be useful in developing effective nursing student-led health promotion programs and interventions for rural older adults. In addition, this study suggests the possibility of nursing student-led health promotion programs centered on community-based learning as an alternative health service.

A scoping review of the implementation and cultural adaptation of school-based mental health promotion and prevention interventions in low-and middle-income countries.

Effective school-based mental health promotion and prevention interventions in low-and middle-income countries (LMICs) can positively impact the mental health and well-being of large numbers of young people. This scoping review aimed to investigate the implementation of effective mental health promotion and prevention interventions in LMIC schools. A scoping review of the international literature was conducted and followed the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews guidelines. Medline, PsycInfo, Scopus, Embase, CINAHL and Cochrane were searched for peer-reviewed literature published from 2014 to 2022. PsycExtra, Google Scholar and the websites of key organisations were searched for relevant grey literature. Study selection focussed on mental health promotion interventions, including the development of social and emotional skills and mental health literacy, and prevention interventions, including anti-bullying and skill-based interventions for "at-risk" students. Twenty-seven studies evaluating 25 school-based interventions in 17 LMICs were included in the review. Fifteen interventions were developed in the implementing country and 10 were adapted from high-income countries (HICs) or other settings. Findings from the studies reviewed were generally positive, especially when interventions were implemented to a high quality. Universal life-skills interventions were found to increase social and emotional skills, decrease problem behaviours and positively impact students' mental health and well-being. Mental health literacy interventions increased mental health knowledge and decreased stigma among students and school staff. Outcomes for externally facilitated anti-bullying interventions were less positive. All 19 effective studies reported on some aspects of programme implementation, and 15 monitored implementation fidelity. Eleven studies outlined the programme's underpinning theoretical model. Only four studies reported on the cultural adaptation of programmes in detail. Including young people in the adaptation process was reported to facilitate natural cultural adaptation of programmes, while input from programme developers was considered key to ensuring that the core components of interventions were retained. The review findings indicate increasing evidence of effective mental health interventions in LMIC schools. To facilitate the sustainability, replication and scaling-up of these interventions, greater attention is needed to reporting on intervention core components, and the processes of implementation and cultural adaptation in the local setting.

Priority actions for promoting population mental health and wellbeing

Mental health promotion is an essential strategy for improving population mental health and wellbeing and preventing poor mental health. This paper outlines the case for governments to invest in promoting population mental health and wellbeing by adopting a mental health promotion approach.Drawing on a synthesis of the international evidence, findings are presented on effective mental health promotion interventions that can be feasibly implemented across the life course in everyday settings and that have the potential to be scaled-up at a country level. Based on a review of 111 meta-analyses and 57 systematic reviews, both universal and targeted interventions are identified, that have been shown to enhance good mental health, reduce the risk of mental ill-health, and advance population health and wellbeing. The implications of the findings for policy and practice are outlined.The policy structures and processes that are needed to support the delivery of evidence-based strategies at a population level are considered, including investing in the systems and capacity to ensure their sustained implementation. In particular, the need for policy models to support intersectoral action at a whole-of-government and whole-of-society level is outlined.

Promoting men's health through sports clubs: a rapid realist review

Abstract Background Traditional health promotion interventions have failed to engage men. Sports clubs offer male-friendly health promotion settings for men, but little is known about implementable intervention strategies and subsequent effects. This rapid realist review (RRR) aims to identify context, mechanisms and effects of health promotion interventions targeting men by or in collaboration with sports clubs. Methods The RRR methodology was developed in collaboration with a panel of Danish practice and policy representatives and international academics. A systematic literature search was conducted in February 2023 for studies published after 2013 in MEDLINE, Embase, and SportDiscus databases and through grey literature sources. Included studies: 1) targeted men aged 18+ years, 2) reported health promotion outcomes, and 3) were delivered primarily by or in collaboration with sports clubs. Results Fifty-two studies were included. Preliminary analyses indicate that interventions delivered through sports clubs show promise for engaging men with high cardiometabolic risk and producing favorable health outcomes. Preliminary findings from the realist synthesis show that if men felt a strong attachment to the sports club (context), it resonated with their feelings of social identity which outweighed a former reluctance to attend health programs (mechanism), and thus increased the men's likelihood for program engagement and health behavior change (outcome). Conclusions Our study indicates that men's health promotion through sports clubs is emergent. While great strides have been made to increase men's involvement in health promoting activities by delivering interventions through sports clubs, research has predominantly focused on select behaviours (e.g., physical activity), sub-groups (e.g., sports fans) and predominantly Caucasian, overweight, middle-aged men.

Green List Prevention - An Evidence Registry for Prevention and Health Promotion in Germany

Abstract Introduction Evidence-based prevention and health promotion will be supported by practice-relevant evidence registries. The Green List Prevention provides an overview of evidence-based prevention programs for children and youth in Germany. It was modeled after the U.S. Blueprints for Healthy Youth Development in the context of the Communities That Care community prevention system. Programs are reviewed for conceptual, implementation, and evaluation quality and are categorized into three levels of evidence: (1) effectiveness theoretically well established, (2) ∼ likely, (3) ∼ proven. The Green List Prevention is used in communities, at state and national levels, and research. This paper provides insight into its content, keywording and enhancements. Methods To characterize the evidence-based programs, an inductive-deductive procedure was used to form 14 super- and 33 subcategories with 226 characteristic attributes. Based on these, all registry entries were categorized and summarized descriptively. Results The 100 programs listed (4/2023) address not only the primary target group of children and adolescents, but also secondary target groups (mainly teachers n = 53, guardians n = 46, educators n = 19) and are located in different environments (mainly school n = 61, family n = 28, kindergarten n = 23). Behavioral prevention on violence including bullying n = 64, addiction n = 47 and mental health n = 34 are in the foreground; topics such as nutrition (n = 3) and physical activity (n = 2) are little represented. Social and life skills programs (n = 61) and training for guardians (n = 25) are listed particularly often. Conclusions The Green List Prevention provides an overview of effective prevention and health promotion interventions for different contexts. Its current expansion to rate environmental and behavioral prevention measures on nutrition and physical Key messages • The Green List Prevention enables stakeholders to make a targeted selection of evidence-based programs and offers practice-relevant information e.g. main focus, program formats, implementation. • The evidence register Green List Prevention supports evidence-based prevention and health promotion in Germany.

Effect of Health Promotion Intervention on Daily Living Activities among Older Adults with Frailty

Effect of Health Promotion Intervention on Daily Living Activities among Older Adults with Frailty

The effectiveness of nurse-led interventions to manage frailty in community-dwelling older people: a systematic review

BackgroundThe global increase in the number of frail older people and the accompanying increase in chronic conditions underline the need to develop effective health promotion and preventive interventions for these population groups. Wide ranging of physical, psychological, and social health factors influence frailty in older people and leads to increased vulnerability to many adverse outcomes. To reverse or reduce the progression of frailty, nurses play a pivotal role in delivering health promotion and preventive interventions. The purpose of the review is to determine the effectiveness of nurse-led interventions in reducing frailty in community-dwelling older people.MethodsThe following electronic databases: PubMed, MEDLINE, Web of Science, SCOPUS, CINAHL, PsychInfo, and WHO Global Index Medicus were searched until June 2022. Nurse-led, "nurse led", education, training, intervention, program, teaching, frail*, fragile*, "frailty syndrome", debility, infirmity, elder*, aged*, old*, geriatric, "community based settings", "community-based", "community setting", community were the search terms. Before data extraction, eligible articles were assessed for their methodological quality. The JBI critical appraisal checklist for reporting experimental studies was utilised to appraise the methodological quality of the studies. Data were systematically examined using a narrative review to determine the effectiveness of the intervention.ResultsOf the 156 studies identified, from the search, six studies with samples ranging from 40 to 1387 older people were eligible for inclusion in the review. Two quasi-experimental studies and one Randomised Controlled Trial (RCT) showed a moderate risk of bias. The Nurse-led frailty interventions used a multi-component intervention approach across the studies. The interventions reversed frailty progression, improve physical functioning, nutritional status, and quality of life, enhance perceptions of social support, improve mental health, and reduce depression.ConclusionsFew studies have explored the effectiveness of a nurse-led intervention to decrease frailty in older people. Evaluating physical functioning, nutritional status, mental health, and quality of life in community-dwelling frail older people can contribute to developing appropriate interventions.Systematic review registrationPROSPERO ID of CRD42022348064.

O.4.4-8 Promoting men’s health through sports clubs: a rapid realist review

Abstract Purpose Traditional health promotion interventions have failed to engage men. Sports clubs offer male-friendly environments that have been identified as an attractive setting for men’s health promotion, but little is known about implementable intervention strategies and subsequent effects. This rapid realist review (RRR) aims to close this gap by assessing context, mechanisms and effects of health promotion interventions targeting men by or in collaboration with sports clubs. Methods The RRR methodology was developed in collaboration with a panel of Danish practice and policy representatives and international academics. A systematic literature search was conducted in February 2023 for studies published after 2013 in MEDLINE, Embase, and SportDiscus databases. Included studies: 1) targeted men aged 18+ years, 2) reported health promotion outcomes, and 3) were delivered primarily by or in collaboration with sports clubs. A grey literature search of National Sports Associations and Federations and non-government men’s health organizations was also performed. Dalkin’s conceptualization of mechanisms in realist methodology was used to identify context- mechanism-outcome configurations (CMOc) and develop a program theory. The study follows Cochrane’s guidance for rapid reviews and is registered in Research Registry (ID: reviewregistry1556). Results We identified 2.720 studies after duplicates removal. Preliminary analyses indicate that interventions delivered through sports clubs show promise for engaging men and producing favorable health outcomes (e.g., weight loss, increased physical activity and improved social support). The realist synthesis suggests that health interventions delivered through sports clubs (resource mechanism) targeted at men who have high attachment to the sport or club (context), may align with their interests and identities (mechanism), to increase the potential for engagement and health behavior change (outcome). The analysis will be finalised by August. Conclusions Our study indicates that men’s health promotion through sports clubs is emergent. While great strides have been made to increase men’s involvement in health promoting activities by delivering interventions through sports clubs, research has predominantly focused on select behaviours (e.g., physical activity) and sub-groups (e.g., sports fans). Support/Funding Source This work was funded by the five Steno Diabetes Centers in Denmark, which are partly funded by the Novo Nordisk Foundation.

Health Promotion Interventions on Helmet Use: A Systematic Review and Meta-Analysis of Pre-Test and Post-Test Studies.

We aimed to review the effectiveness of health promotion interventions in the use of helmet and to identify the types of effective health promotion strategies among the examined studies. A systematic search was performed on the PubMed, Scopus, Cochrane, and Embase databases up to 1 Aug 2022 to find the studies evaluated the effectiveness of health promotion interventions for helmet use among target population. In this systematic review and meta-analysis, interventions with pre- post-test design were included. The dependent variable of the study is the percentage of participants who responded positively toward helmet use in the baseline and after the interventions. Random-effects models were used to pool study results. Overall, 1,675 articles were found in the initial search and entered into the Endnote software. Of these, 917 duplicate articles were removed, leaving 758 articles were screened based on title and abstract. Finally, 12 eligible articles were included in the review and five with pre and post-test design were included in the meta-analysis. The overall random-effects pooled estimation of persons wearing helmets before and after interventions was 70% (95%CI 21 -119; P<0.001), without a heterogeneity (I2 =0%; P=0.94), which means that the average percentage of changing to helmet use is 70%. Community-based education program was the most commonly applied for interventional studies. The next most commonly used approaches were campaign designing. Wearing helmet approximately increased 70% among participant. Health promotion strategies may target helmet-wearing behavior to reduce head injuries in motorcyclist road traffic accidents.

Do Consumers Adhere to a Sustainable Mediterranean Food Pattern? An Analysis of Southern Italian Consumer Practices

The Mediterranean diet (MD) concept has evolved in recent decades, moving from the perception of a healthy diet model to the awareness that it is also a sustainable food model. This dietary model, in fact, brings benefits in terms of nutrition, health, and maintenance of local traditions and food culture, but it also has a better impact in terms of the emission of greenhouse gasses, water and land use, energy consumption, and environment contamination. The aim of this study is to analyze the knowledge of and the adherence to the Mediterranean diet in a sample of adults in southern Italy during 2022, as well as their orientation towards the social dimension of sustainability (in terms of human health and animal welfare) and towards environmental sustainability. To collect information, a questionnaire was prepared for a population of 570 Italian consumers. Using the data from the questionnaires, a multivariate analysis was developed by performing a principal component analysis and a cluster analysis. The results of the empirical analysis proposed by the present study confirm the fact that the analyzed sample lacks adequate knowledge of the MD and, as a result, does not satisfactorily adhere to a healthier lifestyle marked by the criteria of this diet. Most of the clusters derived from the empirical analysis demonstrate low-to-moderate adherence to the MD. There is a need to generate renewed interest in the general population in a sustainable dietary pattern that provides nutritional, environmental, and social benefits. This requires effective health promotion and national interventions to promote the health benefits of the MD.

Het bevorderen van het implementatieproces van Krachtvoer, een lesprogramma over gezonde voeding voor het vmbo

AbstractActively promoting the implementation process of health promotion interventions, ensuring their sufficient and appropriate use in practice, requires a planned approach. Many types of implementation strategies can be used for this purpose, selected on the basis of identified determinants of the implementation process in the specific implementation context. Several phases can be distinguished in the implementation process, namely adoption, actual use, sustainability, scaling up, and de-implementation of the intervention. This article describes which implementation strategies have been and are currently used to promote the implementation process of the educational program Power Food (Krachtvoer), an intervention on healthy nutrition for students in Dutch prevocational secondary schools. It also presents visitor data from the Krachtvoer.nu website during the 2019–2020, 2020–2021 and 2021–2022 school years. A reflection on the approach emphasizes the importance of the leading role of the cross-domain project team, the co-creation with users, and the intersectoral cooperation with the national partner network. A national (funding) policy in the Netherlands to support the sustainability of proven effective and well-implementable health promotion interventions is sorely missed.

Effectiveness of health promotion intervention on the knowledge and selected practices related with oral cancer among a group of vulnerable youth in Sri Lanka

BackgroundThere has been a noticeable trend of younger people being diagnosed with oral cancer, particularly among those from low socio-economic backgrounds. Poor knowledge on risk factors toward oral cancer and the growing fashion of using tobacco also identified among younger generation. Present study aimed to assess the effectiveness of a health promotion intervention to improve the knowledge and encourage positive practices associated with oral cancer among a group of vulnerable youth in Sri Lanka.MethodsThe study was a community based quasi experimental study, conducted in urban slums in the district of Colombo, Sri Lanka. Sample size for one group was 120 youth participants aged between 15 and 24 years. Health promotion intervention was implemented to the intervention group and follow up period was 6 months. The control group did not receive the intervention. Awareness of oral cancer and oral potentially malignant disorders, tobacco chewing practice (betel quid chewing and commercially prepared tobacco and areca nut packet (CPTAP) chewing) and self-mouth examination practice were assessed at the beginning and after 6 months in both groups using an interviewer administered questionnaire. Changes in the knowledge, self-mouth examination practice, quit rate and fresh up take rate were computed to determine the effectiveness.ResultsThere was no loss to follow up. No significant difference was observed between the groups in pre intervention assessment regarding the knowledge, tobacco chewing and self-mouth examination practices. Knowledge score was significantly differed between the groups P = 0.000 in the post intervention assessment as well as among females P = 0.001. Quit rate of the tobacco chewing practice, betel chewing practice and CPTAP chewing practice among intervention group was 33%, 70%, and 13% respectively while control group did not have any quitters, P = 0.001. Fresh up take rate of tobacco chewing in the intervention group was 6.7% compared to the 37.5% in the control group, P = 0.001. Practicing self-mouth examination was significantly higher in intervention group in post intervention assessment, P = 0.000.ConclusionMulticomponent health promotion intervention (Advocacy, Interactive discussions, IEC materials and Community mobilization) was significantly effective in enhancing the knowledge, increasing self-mouth examination practice, and reducing tobacco chewing practice among a vulnerable group of youth in Sri Lanka.

Health Promotion Interventions for Reducing Non-Communicable Diseases (NCDs) in Developing Countries: a case study of India

NCDs are responsible for a significant proportion of premature deaths in developing countries. NCDs can have significant economic costs for individuals, families, and communities in developing countries. These costs can include healthcare expenses, lost productivity, and reduced quality of life. In many developing countries, people do not have access to the healthcare services they need to prevent and manage NCDs. There are several studies conducted on health promotion interventions for reducing non-communicable diseases (NCDs) in developing countries. Some key findings from the studies included community-based interventions which have been found to be effective in reducing NCDs in developing countries. These interventions typically involve engaging community members in health education and awareness programs, providing access to healthy foods and exercise facilities, and promoting healthy lifestyles. It was concluded that effective health promotion interventions include education, improving access to healthcare and healthy food, promoting physical activity, improving water and sanitation, reducing tobacco and alcohol use, and working with communities to develop culturally appropriate strategies. Implementing these interventions requires collaboration between governments, non-governmental organizations, and community groups. Addressing NCDs in developing countries requires a comprehensive and multi-sectoral approach. By implementing effective health promotion interventions, it is possible to prevent and manage NCDs. The study recommended that governments should invest in improving water and sanitation facilities to reduce the risk of NCDs. This can include building new water and sanitation facilities, improving hygiene practices, and promoting the use of clean water and sanitation facilities. Policies should be put in place to lower the usage of fossil fuels, promote the use of clean energy, and regulate industrial and transportation emissions to improve air quality. Keywords: Non-Communicable Diseases, Health Promotion Interventions, Developing Countries, India

Effectiveness of Health Promotion Interventions in Primary Schools-A Mixed Methods Literature Review.

School-based health promotion interventions (HPIs) are commonly used in schools, but scientific evidence about the structures of effective interventions is lacking. Therefore, we conducted a mixed methods systematic literature review to recognize the HPI structures related to their effectiveness. Based on the inclusion criteria, 49 articles were selected for the literature review. The articles, published in 2011-2022, described 46 different school-based interventions conducted in 20 different countries. The average duration of the interventions was 12 months, and they were implemented mostly with an RCT study design (61.2%) and by targeting children (69.4%). Three main groups of interventions were identified and explained: (1) extensive and long-term interventions; (2) school policy-changing interventions; and (3) highly effective interventions. Effective school-based HPIs included multiple target groups, multiple providers with external experts, and an efficient duration and timing of follow-ups. The implications for educational research and school practice are presented. Evidence on the effectiveness of health-related interventions is still lacking and needs to be addressed in further studies.

Expectations on implementation of a health promotion practice using individually targeted lifestyle interventions in primary health care: a qualitative study

BackgroundThere is moderate to strong evidence of the effectiveness of health-promotion interventions, but implementation in routine primary health care (PHC) has been slow. In the Act in Time project implementation support is provided for a health promotion practice using individually targeted lifestyle interventions in a PHC setting. Identifying health care professionals’ (HCPs’) perceptions of barriers and facilitators helps adapt implementation activities and achieve a more successful implementation. This study aimed, at a pre-implementation stage, to describe the expectations of managers, appointed internal facilitators (IFs) and HCPs on implementing a healthy lifestyle-promoting practice in PHC.MethodsIn this qualitative study five focus group discussions with 27 HCPs and 16 individual interviews with managers and appointed IFs were conducted at five PHC centres in central Sweden. The PHC centres are participating in the Act in Time project, evaluating the process and outcomes of a multifaceted implementation strategy for a healthy lifestyle-promoting practice. A deductive qualitative content analysis based on the Consolidated Framework for Implementation Research (CFIR) was followed using inductive analysis.ResultsTwelve constructs from four of five CFIR domains were derived: Innovation characteristics, Outer setting, Inner setting, and Characteristics of individuals. These domains are related to the expectations of HCPs to implement a healthy lifestyle-promoting practice, which includes facilitating factors and barriers. The inductive analysis showed that the HCPs perceived a need for a health-promotion approach to PHC. It serves the needs of the patients and the expectations of the HCPs, but lifestyle interventions must be co-produced with the patient. The HCPs expected that changing routine practice into a healthy lifestyle-promoting practice would be challenging, requiring sustainability, improved structures, cooperation in inter-professional teams, and a common purpose. A collective understanding of the purpose of changing practice was vital to successful implementation.ConclusionsThe HCPs valued implementing a healthy lifestyle-promoting practice in a PHC setting. However, changing routine methods was challenging, implying that the implementation strategy should address obstacles and facilitating factors identified by the HCPs.Trial registrationThis study is part of the Act in Time project, registered in ClinicalTrials.gov with the number NCT04799860. Registered 03 March 2021.

Job Stress and Sleep Disturbances Among Career Firefighters in Northern California.

This study examined the association between job stress and sleep disturbance among career firefighters. A cross-sectional survey study was conducted with 154 career firefighters working in Northern California, US job stress was measured using the short form of the Effort-Reward Imbalance questionnaire and sleep was measured with the Patient-Reported Outcomes Measurement Information System Sleep Disturbance. Approximately 75% experienced sleep disturbance. For firefighters' job stress, high effort (odds ratio [OR] = 3.68; 95% confidence interval [CI]: 1.25-10.80), high effort-reward ratio (OR = 3.55; 95% CI: 1.23-10.23), and high overcommitment (OR = 9.09; 95% CI: 2.30-35.85) were significantly associated with increased likelihood of sleep disturbance, after adjustment for other factors. Job stress significantly affected firefighters' sleep health, suggesting the need to design effective health promotion interventions to reduce job stress and improve sleep quality for these public service workers.

A blended model to support brief interventions in primary care: A qualitative study of usability and acceptability of HealthEir in community pharmacy.

Brief interventions for lifestyle behaviour change are effective health promotion interventions. Primary care settings, including pharmacies, are the most frequently visited healthcare facilities and are well placed to provide brief health interventions. However, despite the evidence-based and policy guidance, barriers to brief interventions have limited their implementation. This study aimed to explore the usability and acceptability of HealthEir, a blended model with digital, print, and communication elements designed to support the delivery of brief health-promoting interventions in pharmacy practice. Usability tests using a think aloud protocol and set tasks (to assess usability) and semi-structured interviews (to assess acceptability) were conducted with fifteen patients and twelve pharmacists. Usability data were analysed deductively using Nielsen's five quality components of usability as a framework. Acceptability data were analysed using inductive thematic analysis. All participants found HealthEir straightforward to use and completed the required tasks without assistance. A small number of patient and pharmacist participants identified opportunity for improvement of the digital element. Acceptability was also high, with individual comments from participants identifying opportunity for improvements to HealthEir, and two patients identifying privacy or safety concerns. The majority of comments regarding acceptability reflected wider social and cultural challenges such as perceptions of the roles of pharmacists and pharmacies and the low priority of preventative health interventions. HealthEir has been demonstrated to be a usable and acceptable support that has the potential to overcome barriers to delivery of brief interventions in pharmacies. Usability and acceptability testing identified minor changes that may further improve its design prior to piloting and implementation.

Clustering of the Adult Population According to Behavioural Health Risk Factors as the Focus of Community-Based Public Health Interventions in Poland

Effective lifestyle health promotion interventions require the identification of groups sharing similar behavioural risk factors (BRF) and socio-demographic characteristics. This study aimed to identify these subgroups in the Polish population and check whether local authorities' health programmes meet their needs. Population data came from a 2018 question survey on a random representative sample of 3000 inhabitants. Four groups were identified with the TwoStep cluster analysis method. One of them ("Multi-risk") differed from the others and the general population by a high prevalence of numerous BRF: 59% [95% confidence interval: 56-63%] of its members smoke, 35% [32-38%] have alcohol problems, 79% [76-82%] indulge in unhealthy food, 64% [60-67%] do not practice recreational physical activity, and 73% [70-76%] are overweight. This group, with an average age of 50, was characterised by an excess of males (81% [79-84%]) and people with basic vocational education (53% [50-57%]). In 2018, only 40 out of all 228 health programmes in Poland addressed BRF in adults; only 20 referred to more than one habit. Moreover, access to these programmes was limited by formal criteria. There were no programmes dedicated to the reduction of BRF exclusively. The local governments focused on improving access to health services rather than on a pro-health change in individual behaviours.

You gotta walk the walk to talk the talk: protocol for a feasibility study of the Happy Older Latino Adults (HOLA) health promotion intervention for older HIV-positive Latino men

BackgroundOlder Latinos living with the human immunodeficiency virus (HIV) have been disproportionately affected by the epidemic and experience compounded health disparities that have deepened over time. These health disparities are largely related to lifestyle and are either preventable or amenable to early detection or intervention. Despite existing resources to deliver an intervention to reduce this compounded health disparity, there is little information on the effects of health promotion interventions on indices of cardiometabolic risk in midlife and older Latinos living with HIV. The Happy Older Latinos are Active (HOLA) intervention is an innovative health promotion program that is uniquely tailored to meet the diverse needs and circumstances of older Latinos with HIV. The goal of this manuscript is to describe the protocol of a feasibility study of the HOLA health promotion intervention for older HIV-positive Latino men.Methods/designHOLA, which is informed by Behavioral Activation and Social Learning theory is a community health worker (CHW)-led, multicomponent, health promotion intervention consisting of: (1) a social and physical activation session; (2) a moderately intense group walk led by a CHW for 45 min, 3×/week for 16 weeks; (3) pleasant events (e.g., going to brunch with friends) scheduling. Eighteen community dwelling Latinos living with HIV aged 50+ will be recruited for this feasibility study adapting the HOLA intervention. Participants will be assessed at three time points (baseline, post-intervention, and 3 months post-intervention) on measures of cardiometabolic risk factors (waist circumference, dyslipidemia, hypertension, and glucose), psychosocial functioning, and health-related quality of life.ConclusionsIf HOLA can be delivered successfully by CHWs, then the scalability, accessibility, and potential for dissemination is increased. Additionally, this study will inform feasibility and identify modifications needed in the design of a larger hypothesis testing study.Trial registrationClinicaltrials.gov Identifier: NCT 03839212. Date of Registration: 8 February, 2019.

Using realist methods for intervention development to fill a methodological gap: A case study showing the development of an oral hygiene intervention for people with intellectual developmental disabilities.

Realist methods offer a novel approach to intervention design. Such novelty is needed for effective oral health promotion interventions with people with intellectual developmental disabilities (IDD) and their carers because existing interventions are poorly described and lack theoretical underpinning. In this study, the steps between inception and final intervention development are presented, with an aim to expand understanding of how realist theorizing can be used to develop interventions, and to demonstrate theory-driven intervention development in the field of oral health promotion. In this intervention development study, the use of realist methods to develop an intervention aiming to improve the oral hygiene of people with IDD is presented. Realist theories (RTs) arising from a mixed synthesis were used to develop the Keep My Teeth intervention. The use of realist theory in intervention development was mapped across seven domains and 18 actions with emphasis on how theory informed key actions. Realist theories informed many but not all actions in the development process. Where gaps arose, this was augmented with other systems of intervention development, such as the Behaviour Change Wheel (BCW) and Behaviour Change Technique (BCT) systems. The resulting intervention and underlying theory are presented using TiDieR criteria. It is demonstrated how realist methods could be integrated with substantive theory when developing an intervention. RTs enhanced the contextualization of the intervention that was developed but were insufficient in their own right to guide the development process from conception to intervention. This was overcome by augmenting with substantive theory, in this case, using the BCW and BCT behaviour change systems, to select and specify the behaviours that needed to change. In essence, the BCTs guided which techniques to select, while the RTs guided how to develop and intervene. Robust intervention development in the field of oral health promotion is also presented in this study.